OBJECTIVE To investigate the incidence rate of nasal septum fracture and it's influence on the effect of nasal bone reduction. METHODS Retrospective analysis of 212 cases of nasal fracture compared with nasal septum deviation were carried out. Among these cases 112 treated with nasal bone reduction only was called group A; the other cases were treated with nasal reduction concomitantly with septoplasty. Among them 58 cases were diagnosed with nasal septum fracture, it was called group B; 42 cases were diagnosed with nasal septum deviation, it was called group C. The postoperative nasal deformity rate was assessed, and the intraoperative findings of nasal septum contrast with preoperative CT diagnosis was analysed. RESULTS Three months after the operation, 27 cases (24.1%) of nasal deformity were found in group A; 9(9.0%) cases of nasal deformity were found in group B+C; septum fracture was found in 58 cases (100%) in group B and 30(71.8%) cases in group C introperatively. The diagnosis rate of nasal septum fracture by CT was 58.0%, while it's incidence rate was 88.0%. CONCLUSION More nasal septum fractures were observed introperatively than CT findings, and septoplasty concomitantly with nasal bone reduction can obviously reduce the rate of nasal deformity.

Objective To analyze the accuracy,sensitivity and safety of multidetector CT angiography(MDCTA) and DSA;furthermore to explore the clinical value of MDCTA in studying the delayed cerebral vasospasm(DCVS) .Methods Delayed cerebral vasospasm was induced in 17 rabbits by injection of autologuous blood into the cisterna magna and followed by a second injection 24 hours later.MDCTA and DSA were carried out at the 7th day before and after the procedure in order to obtain the data of vascular diameter changes for comparative study.Results The basilar artery diameters detected by MDCTA were shown preoperatively as(1.55 ? 0.14) mm and postoperatively as(0.95 ? 0.20) mm;and detected by DSA as(1.61 ? 0.19) mm and(1.00 ? 0.17) mm postoperatively;showing statistically equivalence between the two methods.Conclusions MDCTA is recommended as a reliable,rapid,and minimally invasive diagnostic method,providing a new technique for the delayed cerebral vasospasm research.

OBJECTIVE: To report the experience of canalplasty in treatment of stenosis or atresia of the external auditory canal. METHOD: A retrospective review was performed on 10 patients (10 ears) that underwent canalplasty. The lesions located in bony segment in 1 case, cartilaginous segment in 3 cases, both in cartilaginous and bony segments in 6 cases, in which 4 cases accompanied with the middle ear diseases. All patients received the canalplasty surgery, and tympanoplasty was applied simultaneously if the patient had otitis media. RESULT: Follow-up was conducted for 8-50 months respectively, 8 of the external auditory canal was wide and tympanic membrane gained a good shape, 2 case had stenosis or atresia reoccurrence after the operation. CONCLUSION Appropriate approach and elimination of the lesions thoroughly are key points for the canalplasty.
Adult ; Aged ; Constriction, Pathologic ; surgery ; Ear Canal ; abnormalities ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To study the effects of two different methods of high-pressure injections on imaging quality of synchronous left axillary artery and vein by using volume CT.Methods Forty seven patients who underwent left axillary vein and artery CTA examination study were analyzed retrospectively according to the contrast agent injection scheme and was divided into two groups A and B.Group A of 25 patients used protocol A,adopted clinical routine delay scanning method,via right elbow vein inject contrast medium.Group B of 22 patients used protocol B,adopted artery delayed imaging combined with vein direct imaging method,via right elbow vein,left radial vein inject contrast agent,respectively.Both values of CT and contrast to noise ratio (CNR) of two groups were compared,objective image quality was compared by two blinded readers.Mann Whiteny U test was used.Results The median of CT values for left axillary artery in group A was 151.9 HU.The median of CNR values for left axillary artery in group A was 7.4.The median of CT values for left axillary vein in group A was 116.0 HU.The median of CNR values for left axillary vein in group A was 3.83.The median of CT values for left axillary artery in group B was 348.8 HU.The median of CNR values for left axillary artery in group B was 25.3.The median of CT values for left axillary vein in group B was 497.0 HU.The median of CNR values for left axillary vein in group B was 35.4.Both values of CT and CNR in two groups showed significant difference (Z=-5.735,-5.799,-5.863 and-5.863,P＜0.01).All of the median scores in group B were greater than in group A(P＜0.01).Conclusion The enhancement effect of protocol B in the left axillary arteriovenous synchronous imaging is significantly higher than those of protocol A,and demonstrates clear image quality and clearer anatomic relationship.

Purpose The diagnosis, treatment and prognosis of benign and malignant biliary stricture are significantly different. This study aims to evaluate the quantitative analysis of biliary structures using magnetic resonance cholangiopancreatography (MRCP) combined with dynamic contrast enhanced CT (DCE-CT).Materials and Methods The quantitative parameters of MRCP and DCE-CT imaging data from 27 patients with benign biliary stricture (benign group) and 30 patients with malignant biliary stricture (malignant group) were retrospectively analyzed. The wall thickness, stricture length and diameter, proximal ductal dilatation and degree of enhancement in two groups were compared, and its correlation was analyzed to evaluate the accuracy of MRCP and DCE-CT.Results There were significant differences in wall thickness [(3.2±2.0) mmvs (2.1±0.6) mm], stricture length [(15.8±8.1) mmvs (9.5±6.5) mm] and diameter [0 mmvs (2.0±0.9) mm], proximal ductal dilatation and the degree of enhancement [(12.7±3.6) mmvs (9.3±2.7) mm] between the two groups (t=2.825, 3.270, 4.025,P<0.001;Z=-3.909,P<0.001). Multivariable stepwise regression analysis showed that the wall thickness and diameter, and the CT HU in portal venous and equilibrium phases combined with CT plain scanning were significant predictors of malignant biliary strictures (t=-6.424-2.309,P<0.05). The sensitivity, specificity, inter-modality agreement and Youden index of MRCP and DCE-CT in diagnosing 57 patients with biliary stricture were 96.67%, 100.00%, 98.25% and 0.97, respectively; with statistical significance in predicting benign and malignant biliary stricture (AUC=0.994,P<0.001).Conclusion Using MRCP and DCE-CT, the wall thickness and diameter of the stricture, and the difference in CT HU in portal venous and equilibrium phases combined with CT plain scanning are valuable in differential diagnosis of benign and malignant biliary stricture.

Objective To investigate the risk factors for persistent hemodynamic depression after carotid angioplasty and stenting(CAS). Methods Sixty-one patients with CAS were included. By univariate Logistic regression analysis,the influencing factors for persistent hemodynamic depression were analyzed,by stepwise Logistic regression analysis and adjustment for age and gender factors,the independent risk factors for persistent hemodynamic depression were analyzed. Results In 61 patients,25 cases had hypotension,25 cases had bradycardia,all for 41.0% incidence. According to the patients intraoperative and postoperative blood pressure,heart rate conditions,the duration of hemodynamic depression,the cases were divided into persistent hemodynamic depression group (20 cases) and no-persistent hemodynamic depression group(41 cases). Univariate Logistic regression analysis indicated that persistent hemodynamic depression influencing factors were the symptomatic stenosis, severe stenosis, using balloon dilatation, implantation of laser-carving stent(P<0.05). With adjustment for age and gender factors, stepwise Logistic regression analysis showed that using balloon dilatation, implantation of laser-carving stent were the independent risk factors for persistent hemodynamic depression (OR = 5.046,95%CI 1.342-18.977,P = 0.017;OR = 4.142,95%CI 1.151-14.902, P= 0.030),symptomatic stenosis was the independent protective factor for persistent hemodynamic depression (OR = 0.264,95% CI 0.073-0.964,P= 0.044). Conclusions Persistent hemodynamic depression after CAS is a common complication.CAS patients with using balloon dilatation, implantation of laser-carving stent are more susceptible to persistent hemodynamic depression, while symptomatic stenosis is its protective factor.

Objective To investigate the effect of herpes simplex virus thymidine kinase/ganciclovir (HSV-TK/GGV)system driven by human alpha fetoprotein(AFP)enhancer on hepatocellular carcinoma(HCC)cells in vitro and in vivo.Methods HCC-specific eukarotypic expression vector carrying suicide gene driven by AFP enhancer(pAFP-cDNA3.1-TK)was constructed.The plasmid was trasfected to AFP-positive HepG2 cells and AFP-negative SMMC7721 cells by liposomes.Protein and mRNA expressions of TK were detected by RT-PCR or Western blot.The survival rates of HCC cells were detected by methyl thiazolyl tetrazolium assay.The effects of GGV on the in vitro proliferation,survival and apoptosis of HCC cells were observed,and the inhibitive effect of GGV on the survival of HCC cells in vivo was also detected.All data were analyzed by using the t test.Results The pAFP-cDNA3.1-TK was successfully constructed and transfected to the HCC cells.The protein and mRNA expressions of TK were detected in AFP-positive HepG2 cells.GGV dose-and time-dependently inhibited the growth and induced the apoptosis of HepG2 cells in vitro,but it had no effect on SMMC7721 cells.No protein or mRNA expression of TK was detected in the SMMC7721 cells.There was a significant difference on the inhibitory effects of GGV on HepG2 cells and SMMC7721 cells(t =2.58,2.73,3.12,P ＜0.05).GGV specifically inhibited the growth of AFP-positive HepG2 cells,and the inhibition rate was 46%;the growth of AFP-negative SMMC7721 cells was not influenced by GGV.There was a significant difference in the inhibitive effect of GGV on the growth of HepG2 cells and SMMC7721 cells(t = 3.36,P ＜ 0.05).Conclusion HSV-TK/GGV systemdriven by human APF enhancer kills APF-positive HCC cells and inhibits the growth of HCC cells.

Objective To explore the chiaical value of cerebral perfusion reduction after subarachnoid hemorrhage(SAH)by multi spiral CT perfusion in rabbits.Methods 32 male Japanese big-ear rabbits of clean level were randomly divided into 2 groups:Group A(n =8),the normal group,were to obtain normal MS-CTP values of rabbit cerebrums;Group B(n =24),the SAH group was made into two-hemorrhage animal models,checked on seven day by multi spiral CT perfusion.The source data was transmitted to the post-processing workstation ADW 4.2.Perfusion parameters maps(CBF)of both sides of frontal,parietal and basal ganglia were got by computing.Each rabbit was killed immediately after scanning,and the spider blood was observed.Results The average CBF value of the two groups:The difference was not statistically significant at the frontal(t =1.740,P =0.092)and parietal(t =1.868,P =0.072); The average values of CBF were significantly decreased at the basal ganglia(t =2.481,P =0.019).Group B showed the distribution of blood clot in the basal cistern,but there was no blood clot at the frontal and parietal.Conclusion The monitor perfusion changes of rabbit brain after SAH could be detected by MS-CTP,and the lower of regional cerebral perfusion had a relationship with the distribution with the blood clot,and it could instruct the early diagnosis of cerebral perfusion,and the clinical benefit to early intervention treatment.

ObjectiveTo study the value of C-reactive protein (CRP) and interleukin-6(IL-6) in the (diagnosis) of acute pancreatitis (AP) associated with infection. MethodsSixty SD rats were randomly (assigned) into group AP (n=40) and sham-operation group (S, n=20). Plasma CRP and IL-6 were detected before AP(0h), and at 12h, 24h and 48h after AP. Serum amylase detection and ascitic bacteria culture were carried out at 48h. Results(1)In AP group, 36 rats were alive. Ascitic infection developed in 16 cases (group AP1), and not in the other 20 cases (group AP2). (2)Plasma CRP and IL-6 levels in group AP1 and AP2 were significantly higher than those in group S (all, P0.05). (3)In group AP1, IL-6 and CRP elevated significantly at all time periods after the model setup (P0.05). (Conclusions)Plasma CRP has predictive value in the diagnosis of early infection in acute pancreatitis, but plasma IL-6 is not sensitive to secondary bacteria infection in acute pancreatitis.

Objective To explore the anatomic positional relationship of bronchial artery(BA)with esophagus and main bronchus on 320-detector CTA.Methods Original and post-processed images of 142 patients were observed.Type,origin,opening direction of BA as well as its concomitant relationship with esophagus were recorded.The positional relationship of BA with main bronchus was also recorded by fusing the images of BA and bronchial tree together.Results In 122 patients,273 BA were identified (146 on the right and 127 on the left).Right BA mainly ran simultaneously along the right and posterior edge of the esophagus (49.3%),while left BA mainly ran far gradually on the left side of the esophagus (82.7%).The left and right BA mainly ran along the middle thoracic esophagus, accounting for 58.3% and 42.5% respectively.45.2% of the right BA ran across the posterior edge of the right main bronchus and 60.6% of left BA ran simultaneously on the posterior and up edge of the esophagus.The most dividing direction of BA from the tho-racic aorta was 9 to 12 o’clock with a frequency of 74.2%.Conclusion The concomitant relationship with esophagus of the BA and the positional relationship with main bronchus of the BA could clearly be demonstrated on 320-detector CTA,thus providing availa-ble information and help for pulmonary and mediastinal sugery.